The Relationship Between Neutrophil-lymphocyte Ratio And Lower Limb Atherosclerosis In Type 2 Diabetes Mellitus

Objective The clinical and biochemical data of type 2 diabetes mellitus patients were collected to investigate the relationship between serum neutrophil?lymphocyte ratio and each measurement index,and to explore the relationship between serum neutrophil?lymphocyte ratio and lower limb atherosclerosis in type 2 diabetes mellitus patients.Methods Use the group control study,A total of 173 type 2 diabetes mellitus patients who are admitted to Yan'an university affiliated hospital during October 2012 to December 2015 were recruited and divided into three groups: simple T2 DM group(T),complicated with lower extremity arteries atherosclerosis group(L),complicated with lower extremity arteries and cervical arteries atherosclerosis group(D).The simple T2 DM group 47 cases,of which there is 36 male,11 female,their ages range from 9 to 61 years old;complicated with lower extremity arteries atherosclerosis group 63 cases,of which there is 50 male,13 female,their ages range from 30 to 64 years old;complicated with lower extremity arteries and cervical arteries atherosclerosis group 63 cases,of which there is 46 male,17 female,their ages range from 32 to 79 years old.Collect the patient's general clinical data and biochemical indicators,using SPSS19.0 software for statistics analysis,test the normal distribution of measurement data,by using?X±s expression,non-normal distribution data are transformed to normal distribution data,compare the mean of groups by using analysis of variance,the mean of two groups were compared with LSD methods of analysis of variance,analyze the relation between variables by using Pearson correlation analysis,evaluation the correlation between NLR and lower limb atherosclerosis in type 2 diabetes mellitus patients with Logistic multivariate regression analysis,assess the predictive value of NLR for atherosclerosis in type 2 diabetes mellitus patients with ROC curve.Analyze the difference of NLR among three groups,explore the relationship between serum neutrophil?lymphocyte ratio and lower limb atherosclerosis in type 2 diabetes mellitus patients.Results 1.Comparison of clinical data between simple T2 DM group(T),complicated with lower extremity arteries atherosclerosis group(L)and complicated with lower extremity arteries and cervical arteries atherosclerosis group(D)shows: the average age of three groups are 40.72±11.162 years old?46.62±9.678 years old?54.02±9.960 years old in turn,presents the increasing trend,the difference is statistically significant(P < 0.05);the average diastolic blood pressure level of three groups are 76.38±9.874 mm Hg?81.37±9.688 mm Hg?79.05±9.108 mm Hg in turn,the comparison of the mean between three groups is significant statistically difference,LSD methods of analysis of variance shows that the mean of complicated with lower extremity arteries atherosclerosis group higher than that of simple T2 DM group(P < 0.05);the average body mass index level?systolic blood pressure level of three groups is no significant statistically difference.2.Comparison of biochemical indicators between simple T2 DM group(T),complicated with lower extremity arteries atherosclerosis group(L)and complicated with lower extremity arteries and cervical arteries atherosclerosis group(D)shows: the average total glyceride level of three groups are 2.058±1.058mmol/L ?2.725±2.751mmol/L ?2.033±1.469mmol/L in turn,the comparison of the mean between three groups is significant statistically difference,LSD methods of analysis of variance shows that the mean of complicated with lower extremity arteries and cervical arteries atherosclerosis group lower than that of complicated with lower extremity arteries atherosclerosis group(P < 0.05);the average fasting plasma glucoselevel level? glycated hemoglobin level?total cholesterol level? low density lipoprotein cholesterol level of three groups is no significant statistically difference.3.The difference of NLR mean values between three groups: the average neutrophil?lymphocyte ratio level of three groups are 1.567±0.544?1.832±0.696?2.024±0.769 in turn.Test of homogeneity of variances for NLR shows that the variances is homogeneous(P = 0.329),one way ANOVA for NLR mean values showed that the NLR mean of three groups is not identical,and LSD methods of analysis of variance shows that the NLR mean of simple T2 DM group is lower than that of complicated with lower extremity arteries and cervical arteries atherosclerosis group and complicated with lower extremity arteries atherosclerosis group,the difference is statistically significant(P < 0.05).The mean difference between complicated with lower extremity arteries and cervical arteries atherosclerosis group and complicated with lower extremity arteries atherosclerosis group is no statistically significant(P=0.119).4.The correlation between NLR and the measurement indicators shows that NLR level is associated with age in type 2 diabetes mellitus patients(r=0.178,P= 0.019).5.Logistic regression analysis of atherosclerosis in type 2 diabetes mellitus patients occurred or not for relative factors shows that use atherosclerosis as the dependent variable,use measurement indicators as independent variable,age?DBP?LDL?C?NLR were independent risk factors for atherosclerosis in type 2 diabetes mellitus patients(the value of P is respectively 0.000?0.017?0.043?0.019).6.Evaluate the prediction value of NLR for atherosclerosis in type 2 diabetes mellitus via ROC curve.Atherosclerosis showed by ultrasound examination as diagnostic criteria,NLR value as the test variables,ROC curve analysis shows that the area under the ROC is 0.645,standard error is 0.047,P = 0.003,calculate Youden index and determine the best value,NLR value is 1.325 when Youden index is 0.235.Conclusion 1.The NLR level of simple T2 DM group is lower than that of complicated with atherosclerosis group.2.NLR level is associated with atherosclerosis in type 2 diabetes mellitus patients.3.Age?DBP?LDL?C?NLR were independent risk factors for atherosclerosis in type 2 diabetes mellitus patients.4.In terms of the diagnosis of atherosclerosis in type 2 diabetes mellitus patients,NLR has certain predict value.